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Trial registered on ANZCTR
Registration number
ACTRN12617001421325p
Ethics application status
Submitted, not yet approved
Date submitted
26/09/2017
Date registered
9/10/2017
Date last updated
9/10/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of different post-opervative local anaesthetic infusion locations on recovery after total knee replacement surgery
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Scientific title
A multicentre trial of Continuous Catheters in Adductor Canal versus Femoral Triangle (The CAFE Study) locations for Total Knee Replacement Surgery
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Secondary ID [1]
292976
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Nil known
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Universal Trial Number (UTN)
U1111-1202-7574
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Trial acronym
The CAFE study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Joint replacement
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Adductor canal block
304878
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Condition category
Condition code
Anaesthesiology
304189
304189
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0
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Anaesthetics
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Musculoskeletal
304190
304190
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0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A Continuous femoral triangle block will be undertaken. An experienced regional anaesthetist will perform this procedure in the operating theatre immediately following the total knee replacement surgery. This is a single procedure, undertaken under local anaesthesia, where a small catheter is positioned under ultrasound guidance to lie adjacent to the femoral nerve branches in the mid-thigh (the level of the femoral triangle is identified by visualisation of the anatomical relationships of the thigh muscles - 5cm PROXIMAL to where the medial border of adductor longus muscle crossed the medial border of the sartorius muscle) . This catheter will be attached to a local anaesthetic pain pump for ongoing administration of local anaesthetic in the days following the procedure - 0.5% ropivacaine at 6mL per hour via an ambulatory AmbIT pump (Admedus Australia) for 3 days. All patients will undertake written informed consent before the procedure, including receiving written patient information.
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Intervention code [1]
299216
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Treatment: Other
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Comparator / control treatment
A Continuous adductor canal block will be undertaken. An experienced regional anaesthetist will perform this procedure in the operating theatre immediately following the total knee replacement surgery. This is a single procedure, undertaken under local anaesthesia, where a small catheter is positioned under ultrasound guidance to lie adjacent to the femoral nerve branches in the mid-thigh (the level of the adductor canal is identified by visualisation of the anatomical relationships of the thigh muscles - 5cm DISTAL to where the medial border of adductor longus muscle crossed the medial border of the sartorius muscle) . This catheter will be attached to a local anaesthetic pain pump for ongoing administration of local anaesthetic in the days following the procedure - 0.5% ropivacaine at 6mL per hour via an ambulatory AmbIT pump (Admedus Australia) for 3 days. All patients will undertake written informed consent before the procedure, including receiving written patient information.
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Control group
Active
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Outcomes
Primary outcome [1]
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Timed-Up-And-Go-Test
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Assessment method [1]
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Timepoint [1]
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Post-operative day 1 (22-26 hours)
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Secondary outcome [1]
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Timed-Up-And-Go-Test
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Assessment method [1]
339080
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Timepoint [1]
339080
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Post-operative day 2
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Secondary outcome [2]
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Pain scores - VAS scores rating on a 10 point scale
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Assessment method [2]
339081
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Timepoint [2]
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Post operative day 1 and 2
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Secondary outcome [3]
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Opiate use in oral morphine equivalents (review of medication chart)
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Assessment method [3]
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Timepoint [3]
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Post operative day 1 and 2
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Eligibility
Key inclusion criteria
Adults, aged > 18 years old, not pregnant
Admitted for elective, primary, unilateral, total knee replacement
Mentally competent to provide informed own written consent in English
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Previous total knee replacement surgery to same knee
2. Bilateral knee replacement surgery
3. previously enrolled in study
4. Chronic opioid use; defined as > 20mg oral morphine equivalent per day on average, in the 4 weeks prior to surgery
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer software generated randomised allocation sequence
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary outcome of TUG time between the FTC and ACC groups at POD1 will be analysed using t-tests. Secondary outcomes will be analysed using t-tests, Mann-Whitney U tests, and repeated measures ANOVA. Analysis will use two tailed p < 0.05 for statistical significance.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2018
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Actual
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Date of last participant enrolment
Anticipated
28/06/2018
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Actual
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Date of last data collection
Anticipated
30/06/2018
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Actual
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Sample size
Target
140
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,WA
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [2]
9106
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [3]
9107
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Joondalup Health Campus - Joondalup
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Recruitment postcode(s) [1]
17605
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2050 - Camperdown
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Recruitment postcode(s) [2]
17606
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6009 - Nedlands
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Recruitment postcode(s) [3]
17607
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6027 - Joondalup
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Recruitment outside Australia
Country [1]
9234
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New Zealand
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State/province [1]
9234
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Waikato
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Country [2]
9235
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United States of America
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State/province [2]
9235
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Washington
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Funding & Sponsors
Funding source category [1]
297602
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Hospital
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Name [1]
297602
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Royal Prince Alfred Hospital
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Address [1]
297602
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Missenden Road
Camperdown NSW 2050
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Country [1]
297602
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Australia
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Primary sponsor type
Hospital
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Name
Royal Princa Alfred Hospital
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Address
Missenden Road
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
296616
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Address [1]
296616
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Country [1]
296616
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
298695
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Sydney Local Health District Ethics Review Committee (ERC
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Ethics committee address [1]
298695
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Level 11, KGV Building Missenden Road CAMPERDOWN NSW 2050
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Ethics committee country [1]
298695
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Australia
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Date submitted for ethics approval [1]
298695
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28/08/2017
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Approval date [1]
298695
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Ethics approval number [1]
298695
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Summary
Brief summary
We are testing the hypothesis that Adductor Canal Catheters (ACC) have better quadriceps muscle sparing than Femoral Triangle Catheters (FTC), when used for post-operative analgesia in primary, unilateral total knee replacement surgery. Mobilisation is a key functional outcome after TKR. Ability to participate in physical therapy exercise is an important component of post-operative rehabilitation. This study will investigate if the anatomical location of the catheter used for analgesia impacts on mobilisation and analgesia, as this has recently been raised as a potential point of difference. If the study shows that mobilisation is superior or unchanged for a true adductor canal catheter placement, and analgesia is improved, it casts doubt on the applicability of previous studies. The clinical significance would be that anaesthetists should change the anatomical location for performance of this technique. If the study shows that mobilisation is not different, but analgesia is inferior for the adductor canal catheters, the significance is that while these compartments may be distinct on an anatomical basis, it is not clinically relevant. Anaesthetists can perform the current technique without concern about the theoretical differences raised between the anatomy of the ACC and FTC block.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
77918
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A/Prof Alwin Chuan
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Address
77918
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Department of Anaesthesia
Liverpool Hospital
Liverpool. NSW. 2170
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Country
77918
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Australia
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Phone
77918
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+61 407743668
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Fax
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Email
77918
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[email protected]
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Contact person for public queries
Name
77919
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Alwin Chuan
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Address
77919
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Department of Anaesthesia
Liverpool Hospital
Liverpool. NSW. 2170
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Country
77919
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Australia
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Phone
77919
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+61 407743668
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Fax
77919
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Email
77919
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[email protected]
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Contact person for scientific queries
Name
77920
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Alwin Chuan
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Address
77920
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Department of Anaesthesia
Liverpool Hospital
Liverpool. NSW. 2170
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Country
77920
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Australia
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Phone
77920
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+61 407743668
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Fax
77920
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Email
77920
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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